C型先锋锉和乙二胺四乙酸分次疏通磨牙弯曲钙化根管的临床研究

Clinical management of curved and calcified root canals in molars with C-Pilot files and ethylenediaminetetraacetic acid in multiple visits

目的探讨疏通磨牙弯曲钙化根管的治疗方法。方法实验组选取70例患者72颗磨牙根管中、重度弯曲且下段钙化堵塞的根管136个,采用C型先锋锉结合乙二胺四乙酸(EDTA)制剂分次疏通弯曲钙化根管,机动镍钛根管器械扩大并行冷牙胶侧压充填根管。对照组选取70例患者74颗磨牙中根管中、重度弯曲且下段钙化堵塞的根管139个,采用K锉结合EDTA制剂分次疏通弯曲钙化根管,机动镍钛根管器械扩大并行冷牙胶侧压根管充填。结果实验组136根管中有114根管疏通成功并完成根管治疗,弯曲钙化根管疏通成功率为83.8%,无根管偏移、台阶形成、根管壁侧穿及器械折断发生。对照组139根管中有70根管疏通成功并完成根管治疗,弯曲钙化根管疏通成功率为50.4%,8个根管发生根管偏移及台阶形成,未发生根管壁侧穿及器械分离。结论C型先锋锉与EDTA相结合,采用分次疏通技术,可作为临床上治疗磨牙弯曲钙化根管的有效方法。

Objective To evaluate the negotiating and shaping ability of C-Pilot files and ethylenediaminetetraacetic acid （EDTA） in molar curved and calcified root canals. Methods Experimental group： 72 teeth with 136 moderately or severely curved and calcified canals in 70 patients were negotiated by C-Pilot files and EDTA in multiple visits, and then prepared with ProTaper rotary instruments and obturated with lateral condensation method. Control group： 74 teeth with 139 moderately or severely curved and calcified canals in 70 patients were negotiated by K files and EDTA in multiple visits, then prepared with ProTaper rotary instruments and obturated with lateral condensation method. Pre- and postoperative radiographs were compared to evaluate the treatment outcome. Results Experimental group： by using C-Pilot flies and EDTA, 114/136 moderately or severely curved and calcified canals were successfully prepared and obturated. The original canal curvature were respected and no transportation, ledge, perforation or instrument seperation was recorded. Control group： by using K files and EDTA, 70/139 moderately or severely curved and calcified canals were successfully prepared and obturated. However, 8 canals ended with transportation and ledge. No perforation or instrument seperation was recorded. Conclusions Using C-Pilot files combined with EDTA in multiple visits could be an effective way in negotiating curved and calcified root canals in molars.